Clinical Validation Auditor (CVA) Auditor III
New
J
JobgetherHealthcare auditing
Work remotely from within the United States.Full-TimeMiddle
Salary60,100 - 98,700 USD per year
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Job Details
- Experience
- At least 5 years of acute care experience, preferably in a hospital setting.
- Required Skills
- Microsoft Excel
Requirements
- Hold an active Registered Nurse (RN) license.
- Have at least 5 years of acute care experience, preferably in a hospital setting.
- DRG auditing or clinical coding validation experience is strongly preferred.
- Understand inpatient clinical documentation and apply clinical judgment when reviewing coding and billing accuracy.
- Have strong written communication skills to explain clinical findings and audit decisions clearly and professionally.
- Demonstrate attention to detail, consistency, and analytical problem-solving skills.
- Be proficient with Microsoft Office applications, particularly Excel, Word, and OneNote.
- Be able to work independently, organize time effectively, and maintain focus and productivity in a remote environment.
- Be comfortable managing deadlines and balancing quality expectations with productivity requirements.
- Additional certifications such as CCS, RHIA, or RHIT are advantageous.
- Knowledge of readmission reviews, including Potentially Preventable Readmissions (PPR), is a plus.
- Be willing to complete a brief coding or auditing assessment during the interview process, if required.
Responsibilities
- Review inpatient medical records to determine whether assigned DRG codes are supported by clinical documentation.
- Identify documentation discrepancies, coding inaccuracies, and potential overpayments.
- Document audit findings with clear, evidence-based explanations and rationale.
- Use auditing and coding tools such as 3M and Webstrat to support record reviews and validation decisions.
- Meet established productivity, accuracy, and quality expectations while working independently.
- Stay current with clinical guidelines, DRG requirements, coding rules, and relevant healthcare developments.
- Collaborate with team members to support reliable auditing practices and continuous quality improvement.
- Participate in team meetings and occasional client onsite engagements, with annual travel of up to 10%.
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